Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia.
Blacktown Metabolic and Weight Loss Program, Department of Endocrinology and Diabetes, Blacktown Hospital, Blacktown, Sydney, NSW, Australia.
BMC Psychiatry. 2022 Jul 30;22(1):517. doi: 10.1186/s12888-022-04169-7.
Previous research on the psychological mechanisms of obesity has primarily focused on acute psychopathology. However, there is limited literature on the role of more complex and entrenched psychological processes in weight management. The current study aimed to expand previous research by examining more enduring psychological constructs, including early maladaptive schemas (EMS), schemas modes, and trauma.
Participants (N = 125) comprised adults with normal weight (n = 40) and obesity (n = 85) from community and clinical settings in Australia. Eligible participants completed a series of self-report questionnaires via Research Electronic Data Capture (REDCap). Two, separate, one-way multivariate analysis of variance (MANOVA) were conducted to examine group differences on the outcome variables.
Findings indicated a significant effect of group on EMS and schema modes, V = .51, F(32, 92) = 2.97, p < .001, partial η = .51. Follow-up univariate tests revealed that individuals with obesity endorsed significantly more maladaptive schemas and schema modes and significantly less healthy schema modes than individuals with normal weight. In addition, results demonstrated a significant effect of group on childhood trauma and posttraumatic stress disorder (PTSD) symptoms, V = .19, F(6, 118) = 4.70, p < .001, partial η = .19. Subsequent univariate tests and chi-square analyses indicated that individuals with obesity reported significantly more childhood trauma as well as significantly more PTSD symptoms within the last month than normal weight individuals.
This was the first study to compare EMS and schema modes in treatment-seeking individuals with obesity and normal weight controls using the short form version 3 of the Young Schema Questionnaire and revised, 118-item, Schema Mode Inventory. Overall, findings revealed that individuals with obesity experience more complex and enduring psychological difficulties than normal weight individuals. Increased assessment and targeted treatment of these underlying mental health concerns may contribute to a more holistic conceptualisation of obesity and could improve the long-term success of weight management.
以往关于肥胖心理机制的研究主要集中在急性精神病理学上。然而，关于更复杂和根深蒂固的心理过程在体重管理中的作用的文献有限。本研究旨在通过检查更持久的心理结构，包括早期适应不良模式（EMS）、模式模式和创伤，扩展以前的研究。
参与者（N=125）包括来自澳大利亚社区和临床环境的正常体重（n=40）和肥胖（n=85）成年人。符合条件的参与者通过 Research Electronic Data Capture（REDCap）完成了一系列自我报告问卷。进行了两次独立的单向多元方差分析（MANOVA），以检查组间结果变量的差异。
研究结果表明，组间 EMS 和模式模式存在显著差异，V=0.51，F(32,92)=2.97，p<0.001，部分η=0.51。进一步的单变量检验表明，肥胖个体比正常体重个体更倾向于认同不适应模式和模式模式，而更不认同健康模式模式。此外，结果还表明，组间在儿童创伤和创伤后应激障碍（PTSD）症状方面存在显著差异，V=0.19，F(6,118)=4.70，p<0.001，部分η=0.19。随后的单变量检验和卡方分析表明，肥胖个体报告的儿童创伤和近一个月内的 PTSD 症状明显多于正常体重个体。
这是第一项使用 Young Schema Questionnaire 短版 3 版和修订后的 118 项 Schema Mode Inventory 比较肥胖和正常体重治疗个体的 EMS 和模式模式的研究。总的来说，研究结果表明，肥胖个体比正常体重个体经历更多的复杂和持久的心理困难。增加对这些潜在心理健康问题的评估和针对性治疗可能有助于更全面地理解肥胖，并提高体重管理的长期成功率。
